KARACHI: A study recently published in an international journal highlights the success story of a private organisation that effectively reduced the cases of dog attacks in a small fishing village by vaccinating and controlling canine population.

It emphasises that elimination of rabies is possible only through a collaborative effort driven by a strong political will.

The study — How a private organisation in Pakistan initiated One Health Project to eliminate rabies — is published in IJID One Health (The International Journal of Infectious Diseases). Dr Naseem Salahuddin, senior infectious diseases’ expert at the Indus Hospital, was the principal investigator.

According to the study, over 200 dog-bite cases are reported daily in Karachi at just three tertiary care hospitals, while many victims do not even report to hospitals but apply unsafe home remedies.

36,997 dogs were vaccinated and 11,397 sterilised between 2018 and 2022 in Ibrahim Hyderi

In 2022, the rabies prevention clinic at the Indus Hospital treated over 9,500 dog-bite victims, and more than half of them had deep wounds.

“Not only is rabies a grave problem in low and middle income countries, but it is also hugely underreported and underdiagnosed, while free roaming dogs pose a danger to humans and animals, causing economic losses from livestock deaths. Although the understanding, knowledge, and means to eliminate dog-mediated rabies are available, the government commitment to provide human and financial resources is missing,” the study says.

Generally, people consider the overpopulation of stray dogs as a major hindrance in their daily lives and demand that municipalities deal with it swiftly. The authorities respond through periodical dog-culling campaigns. Unfortunately, such operations do not result in long-term solutions.

Mass dog vaccination

In its response to the escalating dog-bite cases in Karachi, the Indus Hospital Research Centre (IHRC) introduced a pilot programme — Rabies Free Pakistan (RFP) — in 2018 to raise awareness about dog-related rabies in Ibrahim Hyderi and to vaccinate and sterilise unowned dogs in the area.

The programme was based on the ‘One Health’ approach that calls for “collaborative efforts of multiple disciplines working locally, nationally, and globally, to attain optimal health for people, animals and the environment”.

It recommends that vaccination of 70 per cent of dogs in an area would produce herd immunity while controlling the stray dog population through surgical sterilisation would obviate suffering from bites.

The project was run in collaboration with Karachi’s leading veterinarians, animal rights activists, community engagement experts, doctors and researchers. The Karachi municipality and crowdfunding from industry and concerned members of civil society through social media partially provided money.

The WHO provided the animal vaccine and philanthropists donated a stationary container and a mobile van outfitted with air conditioning, water supply, drainage, lights, and fans, improvised to function as an operation theatre for animal birth control. The union committee concerned allowed the use of a large open space to establish RFP’s field office for operating the entire project, along with the provision of utilities and security.

Kennels and cages were installed, and a van was purchased to transport dogs to the treatment facility. The fishermen made poles and dog catching nets after seeing prototypes available online.

The project helped create the much-needed awareness in the community about rabies and post-exposure prophylaxis, while the team vaccinated 36,997dogs and sterilised 11,397 between 2018 and 2022.

“The RFP as a privately-run organisation showed that mass dog vaccination and dog population control are possible in Pakistan and can be replicated, provided that each district’s municipality determines to make their area free of stray dogs and rabies.

“Community engagement, along with innovative tools that require low-cost service delivery strategies that can be replicated on a large scale, will result in the interruption of rabies transmission from free-roaming dogs to humans. We need a massive paradigm shift to achieve the goal of zero human-dog-mediated rabies deaths by 2030,” the study concluded.

“RFP as a privately run organisation showed that mass dog vaccination and dog population control are possible in Pakistan and can be replicated, provided each district’s municipality determines to make their area free of stray dogs and rabies,” said Dr Naseem Salahuddin.

“Community engagement and innovative tools that require low-cost service delivery strategies that can be replicated on a large scale, will interrupt rabies transmission from free-roaming dogs to humans. We need a massive paradigm shift to achieve the goal of zero human-dog-mediated rabies deaths by 2030,” she added.

Published in Dawn, December 28th, 2023